Pediculosis Pubis:
Diagnosis and management
Diagnosis
Observation
of pubic lice or nits attached to the hair. The diagnosis is suggested by
a history of itching and exposure to lice or observation of crabs by the
patient. Pubic lice can also involve eyelashes, eyebrows, beard and body
hair. These areas should be examined.
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| The female crab louse - responsible
for pediculosis pubis. This louse is just visible with the
naked eye - crawling among the pubic hairs. Small eggs (nits)
may be seen attached to the pubic hairs. The most common
symptom is itchiness in the pubic region. |
Pediculosis pubis. |
Management
Treatment
Standard
therapy
permethrin 1% cream rinse topical from chest to knees washed off
after 10 minutes with repeated treatment 1 week later (ADEC B2)
Permethrin
should be applied to clean and cool skin. The patient should not take a
hot bath or shower prior to treatment.
Apply
to infected and adjacent hairy areas
Nits
should be removed with a fine toothed comb.
Sex
partners should be treated concurrently.
Clothing and bed linen contaminated by the patient within the past 2 days
should be washed and dried by machine (hot cycle) or dry cleaned.
If the
eyelashes are infested, white soft paraffin (Lacri-Lube) can be applied to
the lashes, and then the eggs removed, twice a day. This treatment should
be continued for 7 to 10 days.
Patient education
The
following points should be discussed:
-
Nature of the
infection
-
Stress all the therapeutic features, and the need for concurrent
treatment of regular sex partners.
-
Non-sexual transmission of crabs is possible, but in almost all
instances transmission is the result of prolonged close physical
contact.
-
Advise that the itch can last for a few days following treatment.
-
Provide literature on pediculosis.
Follow-up
Required only if
symptoms do not resolve. |
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